The overarching goal of this Competitive Revision [Notice Number (NOT-OD-09-058) and Notice Title ("NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications")] is to expand the scope of our current grant, "In-Home Prevention of Substance Abuse Risks for Native Teen Families," (NIDA 5R01DA019042;FOA: PA-07-070) that is assessing the efficacy of the "Family Spirit" (FS) prenatal and early childhood home- visiting intervention delivered by American Indian (AI) paraprofessionals to AI teen mothers and their children. The current FS intervention is designed to promote mothers'effective parenting practices, reduce maternal drug use, and improve maternal and child outcomes associated with lifetime drug use. The Revision will research current drug use patterns and parenting practices of men who fathered a child with and/or are male partners of AI teen mothers enrolled in the current trial and work with communities to design a data-driven, culturally informed FS supplemental intervention for fathers. Specific aims are to: 1) describe drug use patterns of AI fathers/male partners;2) explore fathers'and community stakeholders'beliefs and motivations regarding drug use and fatherhood;3) examine relationships between fathers'drug use patterns and fathering practices;and 4) design a FS fathers curriculum targeting: a) drug refusal and avoidance;b) effective parenting;c) job readiness, and d) improved home environments. At the time of submission of this Competitive Revision, the sample for the current grant (N=322 mother/child pairs) is recruited and randomized to the FS Intervention + Optimized Standard Care vs. Optimized Standard Care alone. At baseline, expectant AI teen mothers at ~32 weeks gestation from four southwestern reservation communities were 12-19 years old and reported high rates of lifetime drug use. This study aims to recruit 120 fathers (30 from each site) evenly distributed across treatment and control groups and 40 community experts (10 from each site) to advise the intervention development process. Research methods will combine in-depth qualitative research processes with state-of-the-art ACASI technologies to maximize data quality and accelerate transmittal, analysis, and dissemination of findings. Long-term expected outcomes are to reduce persistent AI behavioral health disparities related to drug use over the life course of young AI parents and their offspring. PUBLIC HEALTH RELEVANCE: Given American Indian males'known risks for drug use and their impact on partners and children's drug-related outcomes, there is an urgent need to identify effective intervention strategies for young American Indian fathers. First-time fatherhood may provide a pivotal developmental time point for behavioral redirection and decrease related behavioral risks for partners/spouses and children.